ArticleJournal of general internal medicine2013
Sex disparities in overall burden of disease among HIV-infected individuals in the Veterans Affairs healthcare system.
Article in Journal of general internal medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study.Frontiers in pharmacology · 2021Article
- Sex differences in HIV treatment outcomes and adherence by exposure groups among adults in Guangdong, China: A retrospective observational cohort study.EClinicalMedicine · 2020Article
- Prevalence and Correlates of Self-Rated Successful Aging Among Older Women Living With HIV.Journal of acquired immune deficiency syndromes (1999) · 2019Observational
- Special Topics in the Care of Older People with HIV.Current treatment options in infectious diseases · 2019Article
- An Evidence Map of the Women Veterans' Health Research Literature (2008-2015).Journal of general internal medicine · 2017Review
- Heart failure in patients with human immunodeficiency virus infection: Epidemiology and management disparities.International journal of cardiology · 2016Article
- Beyond the Pap Smear: Gender-responsive HIV Care for Women.The Yale journal of biology and medicine · 2016Review
- Gender-Related Risk Factors Improve Mortality Predictive Ability of VACS Index Among HIV-Infected Women.Journal of acquired immune deficiency syndromes (1999) · 2015Article
- Setting the stage: Research to inform interventions, practice and policy to improve women veterans' health and health care.Journal of general internal medicine · 2013Article
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Authors and funding
13 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundWhether sex disparities exist in overall burden of disease among human immunodeficiency virus (HIV)-infected individuals in the Veterans Affairs healthcare system (VA) is unknown.
objectiveTo determine whether sex differences exist in overall burden of disease after 1 year of combined antiretroviral therapy (ART) among HIV-infected individuals in VA.
designRetrospective cohort study.
participantsAmong patients in the Veterans Aging Cohort Study Virtual Cohort (VACS-VC), all ART-naïve HIV-infected Veterans who received VA-based HIV care between 1996 and 2009. MAIN MEASURES: Overall burden of disease was measured using the VACS Index, an index that incorporates HIV (e.g. CD4 cell count) and non-HIV biomarkers (e.g. hemoglobin) and is highly predictive of all-cause mortality. Possible scores range from 0 to 164, although scores typically range from 0 to 50 for 80 % of patients in VACS-VC. A higher score indicates greater burden of disease (each additional five points indicates approximately 20 % increased 5-year mortality risk). ART adherence was measured using pharmacy data. KEY
resultsComplete data were available for 227 women and 8,073 men. At ART initiation, compared with men, women were younger and more likely to be Black, less likely to have liver dysfunction, but more likely to have lower hemoglobin levels. Median VACS Index scores changed from ART initiation to 1 year after ART initiation: women's scores went from 41 to 28 for women (13 point improvement) and men's from 42 to 27 for men (15 point improvement). In multivariable regression, women had 3.6 point worse scores than men after 1 year on ART (p = 0.002); this difference decreased to 3.2 points after adjusting for adherence (p = 0.004).
conclusionsIn VA, compared to men, women experienced less improvement in overall burden of disease after 1 year of HIV treatment. Further study is needed to elucidate the modifiable factors that may explain this disparity.
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